Idiopathic Colonic Varices: A Rare Cause of Recurrent Lower Gastrointestinal Bleeding

Colonoscopy was significant for diverticulosis, the presence of small nonbleeding colonic angioectasia, and a nonspecific mucosa vascular pattern in the rectosigmoid, transverse, and ascending colon consistent with varicosities (Figure 1). Biopsy revealed moderate congestion and inflammation without signs of angiodysplasia or colitis. Esophagogastroduodenoscopy did not reveal esophageal varices, gastric varices, portal hypertensive gastropathy, or congestion. Laboratory evaluation showed no anemia or abnormalities consistent with cirrhosis. Computed tomographic angiography of the abdomen and pelvis revealed an 0.8-cm distal splenic artery aneurysm. No signs of portal hypertension, fibrosis, cirrhosis, necrosis, or mesenteric artery or venous thrombosis were noted. Liver biopsy and hepatic vein pressure were not obtained due to low suspicion of liver involvement from history, imaging, and laboratory values.